The ABCs of Mental Health: Understanding Childhood Disorders and Treatment Amidst Back-to-School Season
As summer ends and we head into the school season, now is a great time to check in on the mental health of our children. Mental health is an important part of children’s overall health and well-being. Mental health includes children’s mental, emotional, and behavioral well-being. It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others, and make healthy choices. Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, causing distress and problems getting through the day.
What are the common mental health disorders in children?
Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders. Estimates for ever having a diagnosis among children aged 3-17 years, in 2016-19, are as follows; ADHD 9.8%, anxiety 9.4%, behavior problems 8.9% and depression 4.4%. Mental, behavioral, and developmental disorders begin in early childhood. 1 in 6 U.S. children aged 2–8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder
How does bullying impact children’s mental health?
Exposure to bullying at school was associated with higher odds of mental health problems. Boys appear to be more vulnerable to the deleterious effects of bullying than girls. Bullying is associated with severe symptoms of mental health problems, including self-harm and suicidality. Bullying was shown to have detrimental effects that persist into late adolescence and contribute independently to mental health problems. Updated reviews have presented evidence indicating that bullying is causative of mental illness in many adolescents.
How childhood pressure can impact a child’s mental health
There are many sources of pressure in a child’s life; parents, coaches, teachers, friends, society and themselves. Even if a parent isn’t pushing their kid to the breaking point, kids may be putting intense pressure on themselves because they feel they need to compete with their peers in order to be successful in life.
For so many kids in high-achieving districts, resume building begins at a very young age. They are encouraged to do as many activities as possible, excel at all of them and get good grades too, all so they can increase their chances of getting into the best college possible in order to have a successful future. This puts a lot of pressure on kids and teens.
How do biological changes affect kids?
There is increasing evidence that puberty influences mental health and emotional well-being in humans in multiple ways. These effects begin with adrenarche in late childhood and continue with gonadarche in early adolescence. Puberty itself is associated with increased behavioral problems in boys and increased social anxiety, depression and self-harm in girls. It is also associated with a lower sense of well-being and with increased reports of fatigue, irritability and somatic complaints. The mechanisms by which puberty influences mental health are unclear, and likely encompass biological and sociological pathways.
Pubertal timing appears to have effects that are separate from the processes of puberty itself, although it is uncertain whether those with earlier puberty simply enter this risk period earlier than peers. However, it is also possible that early puberty and adolescent mental health problems share a range of common risk factors. These may include stressful family environments, early childhood adversity, sexual abuse and lack of parental investment or warmth.
Identifying issues and next steps – Evaluations and Treatment
Young children may benefit from an evaluation and treatment if they have frequent tantrums or are intensely irritable much of the time, often talk about fears or worries, complain about frequent stomachaches or headaches with no known medical cause, are in constant motion and cannot sit quietly (except when they are watching videos or playing video games), sleep too much or too little, have frequent nightmares, or seem sleepy during the day, are not interested in playing with other children or have difficulty making friends, struggle academically or have experienced a recent decline in grades, repeat actions or check things many times out of fear that something bad may happen.
Older children and adolescents may benefit from an evaluation and treatment if they have lost interest in things that they used to enjoy, have low energy, sleep too much or too little or seem sleepy throughout the day, are spending more and more time alone and avoid social activities with friends or family, diet or exercise excessively, or fear gaining weight, engage in self-harm behaviors (such as cutting or burning their skin), smoke, drink, or use drugs, engage in risky or destructive behavior alone or with friends, have thoughts of suicide, have periods of highly elevated energy and activity and require much less sleep than usual, say that they think someone is trying to control their mind or that they hear things that other people cannot hear.
If you are concerned about your child’s mental health, you can start by talking with others who frequently interact with your child. You can talk with your child’s pediatrician or health care provider and describe the child’s behavior, as well as what you have observed and learned from talking with others. You also can ask the health care provider for a referral to a mental health professional who has experience and expertise in treating children.
- Angold A, Costello EJ, Worthman CM (1998) Puberty and depression: the roles of age, pubertal status and pubertal timing. Psychol Med 28:51–61
- Arseneault L. The long-term impact of bullying victimization on mental health. World Psychiatry. 2017;16(1):27–8. https://doi.org/10.1002/wps.20399.
- Perou R, Bitsko RH, Blumberg SJ, Pastor P, Ghandour RM, Gfroerer JC, Hedden SL, Crosby AE, Visser SN, Schieve LA, Parks SE, Hall JE, Brody D, Simile CM, Thompson WW, Baio J, Avenevoli S, Kogan MD, Huang LN. Mental health surveillance among children – United States, 2005—2011. MMWR 2013;62(Suppl; May 16, 2013):1-35.
- Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith DS, Kaminski JW, Kenney MK, Peacock G. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2–8 years — United States, 2016. MMWR, 2018;67(5):1377-1383.
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